Provider Demographics
NPI:1396225108
Name:KAUFFMAN, SOPHIE ALICE ELIZABETH (MS, RD)
Entity Type:Individual
Prefix:
First Name:SOPHIE
Middle Name:ALICE ELIZABETH
Last Name:KAUFFMAN
Suffix:
Gender:F
Credentials:MS, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1908 E 16TH AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99203-3626
Mailing Address - Country:US
Mailing Address - Phone:206-450-3000
Mailing Address - Fax:
Practice Address - Street 1:2020 E 29TH AVE STE 200
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99203-3948
Practice Address - Country:US
Practice Address - Phone:866-821-0281
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-21
Last Update Date:2022-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA86069604133V00000X
WADI60892743133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered